Quality of life, symptoms and care needs in patients with persistent or recurrent platinum-resistant ovarian cancer: An NRG Oncology/Gynecologic Oncology Group study

Vivian E. von Gruenigen; Helen Q. Huang; David Cella; Michael A. Zevon; Jason A. LaChance; Joan L. Walker; Ritu Salani; Susan C. Modesitt; Robert T. Morris; William H. Bradley; Matthew P. Boente; Lari Wenzel

doi:10.1016/j.ygyno.2018.05.017

Quality of life, symptoms and care needs in patients with persistent or recurrent platinum-resistant ovarian cancer: An NRG Oncology/Gynecologic Oncology Group study

Vivian E. von Gruenigen^*, Helen Q. Huang, David Cella, Michael A. Zevon, Jason A. LaChance, Joan L. Walker, Ritu Salani, Susan C. Modesitt, Robert T. Morris, William H. Bradley, Matthew P. Boente, Lari Wenzel

^*Corresponding author for this work

Medical Social Sciences

Research output: Contribution to journal › Article › peer-review

12 Scopus citations

Abstract

Objectives: The goals of treating recurrent platinum-resistant ovarian cancer are palliative, aimed at reducing symptoms and improving progression free survival. A prospective trial was conducted to determine the prevalence and severity of symptoms, and associated care needs. Methods: Eligible women included those with persistent or recurrent platinum-resistant ovarian cancer with an estimated life expectancy of at least 6 months. The Needs at the End-of-Life Screening Tool (NEST), FACIT-Fatigue (FACIT-F), NCCN-FACT Ovarian Symptom Index [NFOSI-18]; Disease Related Symptoms (DRS), Treatment Side Effects (TSE), and Function/Well Being (F/WB) were collected at study entry, 3 and 6 months. Results: We enrolled 102 evaluable patients. Initiation of Do Not Resuscitate (DNR) discussions increased over time from 28% at study entry to 37% at 6 months. At study entry, the most common disease-related symptoms were fatigue (92%), worry (89%), and trouble sleeping (76%); 73% reported being “bothered by treatment side effects”, which included nausea (41%) and hair loss (51%) neither of which changed over time. The most common NEST unmet needs were in the symptom dimension. The social dimension was associated with F/WB (p = 0.002) and FACIT-F (p = 0.006); symptoms were associated with DRS (p = 0.04), TSE (p = 0.03), and FACIT-F (p = 0.04); existential was not associated with any of the patient-reported symptoms; therapeutic was associated with F/WB (p = 0.02). Conclusions: In patients nearing the end of life, there are significant associations between disease and treatment related symptoms and unmet patient needs, which do not change substantially over time. Careful exploration of specific end-of-life care needs can improve patient-centered care and QOL.

Original language	English (US)
Pages (from-to)	119-126
Number of pages	8
Journal	Gynecologic oncology
Volume	150
Issue number	1
DOIs	https://doi.org/10.1016/j.ygyno.2018.05.017
State	Published - Jul 2018

Keywords

Care needs
Ovarian cancer
Quality of life
Symptoms

ASJC Scopus subject areas

Oncology
Obstetrics and Gynecology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.ygyno.2018.05.017

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von Gruenigen, V. E., Huang, H. Q., Cella, D., Zevon, M. A., LaChance, J. A., Walker, J. L., Salani, R., Modesitt, S. C., Morris, R. T., Bradley, W. H., Boente, M. P., & Wenzel, L. (2018). Quality of life, symptoms and care needs in patients with persistent or recurrent platinum-resistant ovarian cancer: An NRG Oncology/Gynecologic Oncology Group study. Gynecologic oncology, 150(1), 119-126. https://doi.org/10.1016/j.ygyno.2018.05.017

@article{05966205c6c14d609814751750ed8c89,

title = "Quality of life, symptoms and care needs in patients with persistent or recurrent platinum-resistant ovarian cancer: An NRG Oncology/Gynecologic Oncology Group study",

abstract = "Objectives: The goals of treating recurrent platinum-resistant ovarian cancer are palliative, aimed at reducing symptoms and improving progression free survival. A prospective trial was conducted to determine the prevalence and severity of symptoms, and associated care needs. Methods: Eligible women included those with persistent or recurrent platinum-resistant ovarian cancer with an estimated life expectancy of at least 6 months. The Needs at the End-of-Life Screening Tool (NEST), FACIT-Fatigue (FACIT-F), NCCN-FACT Ovarian Symptom Index [NFOSI-18]; Disease Related Symptoms (DRS), Treatment Side Effects (TSE), and Function/Well Being (F/WB) were collected at study entry, 3 and 6 months. Results: We enrolled 102 evaluable patients. Initiation of Do Not Resuscitate (DNR) discussions increased over time from 28% at study entry to 37% at 6 months. At study entry, the most common disease-related symptoms were fatigue (92%), worry (89%), and trouble sleeping (76%); 73% reported being “bothered by treatment side effects”, which included nausea (41%) and hair loss (51%) neither of which changed over time. The most common NEST unmet needs were in the symptom dimension. The social dimension was associated with F/WB (p = 0.002) and FACIT-F (p = 0.006); symptoms were associated with DRS (p = 0.04), TSE (p = 0.03), and FACIT-F (p = 0.04); existential was not associated with any of the patient-reported symptoms; therapeutic was associated with F/WB (p = 0.02). Conclusions: In patients nearing the end of life, there are significant associations between disease and treatment related symptoms and unmet patient needs, which do not change substantially over time. Careful exploration of specific end-of-life care needs can improve patient-centered care and QOL.",

keywords = "Care needs, Ovarian cancer, Quality of life, Symptoms",

author = "{von Gruenigen}, {Vivian E.} and Huang, {Helen Q.} and David Cella and Zevon, {Michael A.} and LaChance, {Jason A.} and Walker, {Joan L.} and Ritu Salani and Modesitt, {Susan C.} and Morris, {Robert T.} and Bradley, {William H.} and Boente, {Matthew P.} and Lari Wenzel",

note = "Funding Information: This study was supported by National Cancer Institute grants to the Gynecologic Oncology Group (GOG) Administrative Office (CA 27469), the Gynecologic Oncology Group Statistical Office (CA 37517), NRG Oncology SDMC (1U10 CA180822) and NRG Operations (U10CA180868). The following Gynecologic Oncology Group member institutions participated in the primary treatment studies: University of Oklahoma Health Sciences Center, Women and Infants Hospital, Ohio State University Comprehensive Cancer Center, University of Virginia, Carolinas Medical Center/Levine Cancer Institute, Metro-Minnesota CCOP, University of California Medical Center at Irvine-Orange Campus, Wayne State University/Karmanos Cancer Institute, Froedtert and the Medical College of Wisconsin, Washington University School of Medicine, University of Wisconsin Hospital and Clinics, Baystate Medical Center, Cancer Research for the Ozarks NCORP, Mainline Health CCOP, University of New Mexico, University of Massachusetts Memorial Health Care, Case Western Reserve University, The Hospital of Central Connecticut, Evanston CCOP-NorthShore University Health System, Michigan Cancer Research Consortium Community Clinical Oncology Program, Northern Indiana Cancer Research Consortium, Northwestern University, University of Colorado Cancer Center – Anschutz Cancer Pavilion, Rush University Medical Center, State University of New York Downstate Medical Center, MD Anderson Cancer Center, University of Chicago and Wichita CCOP. Publisher Copyright: {\textcopyright} 2018 Elsevier Inc.",

year = "2018",

month = jul,

doi = "10.1016/j.ygyno.2018.05.017",

language = "English (US)",

volume = "150",

pages = "119--126",

journal = "Gynecologic Oncology",

issn = "0090-8258",

publisher = "Academic Press Inc.",

number = "1",

}

von Gruenigen, VE, Huang, HQ, Cella, D, Zevon, MA, LaChance, JA, Walker, JL, Salani, R, Modesitt, SC, Morris, RT, Bradley, WH, Boente, MP & Wenzel, L 2018, 'Quality of life, symptoms and care needs in patients with persistent or recurrent platinum-resistant ovarian cancer: An NRG Oncology/Gynecologic Oncology Group study', Gynecologic oncology, vol. 150, no. 1, pp. 119-126. https://doi.org/10.1016/j.ygyno.2018.05.017

TY - JOUR

T1 - Quality of life, symptoms and care needs in patients with persistent or recurrent platinum-resistant ovarian cancer

T2 - An NRG Oncology/Gynecologic Oncology Group study

AU - von Gruenigen, Vivian E.

AU - Huang, Helen Q.

AU - Cella, David

AU - Zevon, Michael A.

AU - LaChance, Jason A.

AU - Walker, Joan L.

AU - Salani, Ritu

AU - Modesitt, Susan C.

AU - Morris, Robert T.

AU - Bradley, William H.

AU - Boente, Matthew P.

AU - Wenzel, Lari

N1 - Funding Information: This study was supported by National Cancer Institute grants to the Gynecologic Oncology Group (GOG) Administrative Office (CA 27469), the Gynecologic Oncology Group Statistical Office (CA 37517), NRG Oncology SDMC (1U10 CA180822) and NRG Operations (U10CA180868). The following Gynecologic Oncology Group member institutions participated in the primary treatment studies: University of Oklahoma Health Sciences Center, Women and Infants Hospital, Ohio State University Comprehensive Cancer Center, University of Virginia, Carolinas Medical Center/Levine Cancer Institute, Metro-Minnesota CCOP, University of California Medical Center at Irvine-Orange Campus, Wayne State University/Karmanos Cancer Institute, Froedtert and the Medical College of Wisconsin, Washington University School of Medicine, University of Wisconsin Hospital and Clinics, Baystate Medical Center, Cancer Research for the Ozarks NCORP, Mainline Health CCOP, University of New Mexico, University of Massachusetts Memorial Health Care, Case Western Reserve University, The Hospital of Central Connecticut, Evanston CCOP-NorthShore University Health System, Michigan Cancer Research Consortium Community Clinical Oncology Program, Northern Indiana Cancer Research Consortium, Northwestern University, University of Colorado Cancer Center – Anschutz Cancer Pavilion, Rush University Medical Center, State University of New York Downstate Medical Center, MD Anderson Cancer Center, University of Chicago and Wichita CCOP. Publisher Copyright: © 2018 Elsevier Inc.

PY - 2018/7

Y1 - 2018/7

N2 - Objectives: The goals of treating recurrent platinum-resistant ovarian cancer are palliative, aimed at reducing symptoms and improving progression free survival. A prospective trial was conducted to determine the prevalence and severity of symptoms, and associated care needs. Methods: Eligible women included those with persistent or recurrent platinum-resistant ovarian cancer with an estimated life expectancy of at least 6 months. The Needs at the End-of-Life Screening Tool (NEST), FACIT-Fatigue (FACIT-F), NCCN-FACT Ovarian Symptom Index [NFOSI-18]; Disease Related Symptoms (DRS), Treatment Side Effects (TSE), and Function/Well Being (F/WB) were collected at study entry, 3 and 6 months. Results: We enrolled 102 evaluable patients. Initiation of Do Not Resuscitate (DNR) discussions increased over time from 28% at study entry to 37% at 6 months. At study entry, the most common disease-related symptoms were fatigue (92%), worry (89%), and trouble sleeping (76%); 73% reported being “bothered by treatment side effects”, which included nausea (41%) and hair loss (51%) neither of which changed over time. The most common NEST unmet needs were in the symptom dimension. The social dimension was associated with F/WB (p = 0.002) and FACIT-F (p = 0.006); symptoms were associated with DRS (p = 0.04), TSE (p = 0.03), and FACIT-F (p = 0.04); existential was not associated with any of the patient-reported symptoms; therapeutic was associated with F/WB (p = 0.02). Conclusions: In patients nearing the end of life, there are significant associations between disease and treatment related symptoms and unmet patient needs, which do not change substantially over time. Careful exploration of specific end-of-life care needs can improve patient-centered care and QOL.

AB - Objectives: The goals of treating recurrent platinum-resistant ovarian cancer are palliative, aimed at reducing symptoms and improving progression free survival. A prospective trial was conducted to determine the prevalence and severity of symptoms, and associated care needs. Methods: Eligible women included those with persistent or recurrent platinum-resistant ovarian cancer with an estimated life expectancy of at least 6 months. The Needs at the End-of-Life Screening Tool (NEST), FACIT-Fatigue (FACIT-F), NCCN-FACT Ovarian Symptom Index [NFOSI-18]; Disease Related Symptoms (DRS), Treatment Side Effects (TSE), and Function/Well Being (F/WB) were collected at study entry, 3 and 6 months. Results: We enrolled 102 evaluable patients. Initiation of Do Not Resuscitate (DNR) discussions increased over time from 28% at study entry to 37% at 6 months. At study entry, the most common disease-related symptoms were fatigue (92%), worry (89%), and trouble sleeping (76%); 73% reported being “bothered by treatment side effects”, which included nausea (41%) and hair loss (51%) neither of which changed over time. The most common NEST unmet needs were in the symptom dimension. The social dimension was associated with F/WB (p = 0.002) and FACIT-F (p = 0.006); symptoms were associated with DRS (p = 0.04), TSE (p = 0.03), and FACIT-F (p = 0.04); existential was not associated with any of the patient-reported symptoms; therapeutic was associated with F/WB (p = 0.02). Conclusions: In patients nearing the end of life, there are significant associations between disease and treatment related symptoms and unmet patient needs, which do not change substantially over time. Careful exploration of specific end-of-life care needs can improve patient-centered care and QOL.

KW - Care needs

KW - Ovarian cancer

KW - Quality of life

KW - Symptoms

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SN - 0090-8258

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JO - Gynecologic Oncology

JF - Gynecologic Oncology

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ER -

Quality of life, symptoms and care needs in patients with persistent or recurrent platinum-resistant ovarian cancer: An NRG Oncology/Gynecologic Oncology Group study

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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